Johns Hopkins researchers are establishing a screening service that uses an automated camera to identify diabetics with a potentially blinding eye disease long before they sustain permanent damage and lose vision.

The device, called the DigiScope, is a version of similar devices used by ophthalmologists to photograph retinas, says the inventor, Ran Zeimer, Ph.D., professor of ophthalmology at Wilmer Eye Institute. However, unlike other devices that take pictures of the retina--the light-sensitive part of the eye--the DigiScope can be operated by the office staff of primary care physicians, Zeimer says. This eliminates the need for diabetics to visit ophthalmologists to get screened for diabetic retinopathy, a disease that destroys the retina.

Conventional cameras used to take pictures of the retina require a trained photographer to obtain several images through the pupil from different angles in order to get a wide, three-dimensional view of the retina for accurate diagnosis. The DigiScope gives the same information with a single image suitable for diagnosing diabetic retinopathy. Instead of film, the camera sends the image by computer e-mail from the screening office to specialists who interpret the image and decide if a patient needs to be referred to an ophthalmologist.

Hopkins, which holds the patent to the DigiScope, has signed a license agreement with EyeTel Imaging Corporation (Centreville, Va.), giving the company worldwide rights to market the device. In exchange, EyeTel will fund research at Wilmer to complete development of the DigiScope and pay royalties on income derived from marketing the company's screening business, Expert Remote Imaging Service of the Eye (EyeRIS) . Wilmer also will set up a reading center to service the mid-Atlantic area. EyeTel Imaging will distribute the DigiScope to primary care physicians and charge a fee for each exam.

Initial tests of the system have begun with Columbia Medical Plan, a Maryland-based health maintenance organization, and Henry Ford Hospital in Detroit.

Diabetic retinopathy is the most frequent cause of new cases of blindness in people 20 to 74 years of age. The screening program will be expanded in the future to include glaucoma and age-related macular degeneration, also major causes of blindness in the United States.

"Having a yearly eye exam is the best way to catch diabetic retinopathy," Zeimer says. "But not all health care plans pay for that, and not all diabetics take the time to make an appointment. So the best way to catch the disease early is to make it easy during a regular checkup with the primary care doctor."